Ongoing analysis of data from the North Carolina Kidney Disease Study concerns the potential risk associated with self-reported job history and specific occupational exposures, including solvents, dusts, metals and silica. Our study included 548 cases with renal disfunction confirmed by hospital chart review and 514 matched population controls. A paper in revision assessed risk of chronic kidney disease in relation to work in agriculture and manufacturing jobs in the presence of dusty conditions. We previously reported that occupational silica exposure was associated with increased chonic kidney disease risk. In related work using the Agricultural Health Study Cohort we are studying the potential association between pesticide use and kidney disease by linking the cohort to mortality records in Iowa and North Carolina. We also linked the cohort to the US Renal Data System to evaluate risk for incident End Stage Renal Disease (ESRD). In that study we found a positive exposure-response trend for five herbicides and one insecticide in relation to risk for end stage renal disease. We also found that doctor visits and hospitalizations due to unusually high pesticide exposures were also related in increased risk for future renal failure. Using the Agricultural Health Study we also identified novel links between use of specific pesticides and risk for diabetes in spouses. Findings were similar to our previous evaluation of risk among licensed pesticide applicators. We also found increased prevalence of hypothyroid disease among applicators and spouses exposed to a range of pesticide subtypes. A recently completed analysis explored risk for endometriosis in spouses of applicators who themselves report use of specific single and combination pesticides. In the ADHD study we reported that the prevalence of ADHD in school-aged children is higher than previously published estimates and that the specific method used to define case status has significant impact on disease prevalence estimates. We are studying a range of autoimmune diseases and autoimmunity using data collected in the Sister and Agricultural Health Study Cohorts as well as using population data such as NHANES and data from other studies such as the NIEHS Myositis registry (in collaboration with Drs. Miller and Rider in the NIEHS Autoimmunity Research Group) and the Women's Health Initiative. Dr. Parks studied risk factors for antinuclear antibodies using the National Health and Nutrition Survey finding differences associated with reproductive characteristic in women. She also studied associations between elevated C-reactive protein and self-reported flares in SLE patients and is exploring psychosocial and other stressors in relation to RA using data from the Women's Health Initiative. A new project in collaboration with investigators from NIA is evaluating changes in ANA over time, exploring associations between vitamin D and other factors with ANA levels and trajectories, and evaluating whether ANA levels are associated with telomere shortening over time. To date, ANA has been measured for selected participants at two time periods and analyses of changes over time and association between ANA and vitamin D deficiency are in progress.